Six-year experience of oncoplastic volume replacement using local perforator flaps

Area of Science:

• Oncology
• Plastic Surgery
• Breast Surgery

Background:

• Breast-conserving surgery (BCS) can result in volume defects.
• Local perforator flaps offer a solution for volume reconstruction after BCS.
• These flaps can improve cosmetic outcomes and avoid contralateral symmetrisation.

Purpose of the Study:

• To assess long-term oncological outcomes of local perforator flap reconstruction.
• To demonstrate the learning curve for implementing these techniques.
• To evaluate the impact on patient outcomes and surgical practice.

Main Methods:

• A consecutive case series of 116 local perforator flaps from January 2014 to May 2020.
• Data collected included patient demographics, tumor characteristics, surgical details, complications, and follow-up.
• Annual mammographic surveillance for a minimum of five years for all breast cancer patients.

Main Results:

• 101 immediate and 15 delayed reconstructions were performed.
• Overall complication rate was 15%, primarily minor infections; 1.7% required hematoma evacuation.
• At a median follow-up of 37 months, no local cancer recurrences were observed.

Conclusions:

• Local perforator flaps are associated with low morbidity, excellent oncological outcomes, and long-term durability.
• These flaps expand BCS indications, potentially reducing mastectomy rates.
• Implementation shows a learning curve with increased lesion size, decreased operative times, and more day-case procedures over time.